Healthcare Provider Details

I. General information

NPI: 1174260962
Provider Name (Legal Business Name): SOLID GROUND PSYCHIATRY PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2022
Last Update Date: 05/26/2023
Certification Date: 05/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 PINE HAVEN SHORES RD STE 1011
SHELBURNE VT
05482-7812
US

IV. Provider business mailing address

145 PINE HAVEN SHORES RD STE 1011
SHELBURNE VT
05482-7812
US

V. Phone/Fax

Practice location:
  • Phone: 802-488-0048
  • Fax: 802-209-8024
Mailing address:
  • Phone: 802-448-0048
  • Fax: 802-209-8024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSEPH LASEK
Title or Position: OWNER
Credential: MD
Phone: 802-448-0048